| NPI | 1528624160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8040) |
| Enumeration Date | 2019-05-18 |
| Last Update Date | 2023-02-10 |