| NPI | 1699085274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8691) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002159) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2023-09-18 |