| NPI | 1639507882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7645) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0890) |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2023-12-11 |