| NPI | 1457952871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8214) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59008) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2024-04-24 |