| NPI | 1558077016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9564) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NV PA2777) |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-09-18 |