| NPI | 1518703974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11116) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 5469) |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2025-08-19 |