| NPI | 1700559770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11121) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 328191) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-07-14 |