| NPI | 1659065720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11913) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA66942) |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2026-08-10 |