| NPI | 1629606983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8290) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 8290) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-10-03 |