| NPI | 1457800302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6500) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 6500) | |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2024-11-21 |