| NPI | 1679556641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3331) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 3331) |
| 363AM0700X Physician Assistant Medical (Licence: AZ 3331) | |
| 363AS0400X Physician Assistant Surgical (Licence: AZ 3331) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2020-09-03 |