| NPI | 1720086994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10387) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002185L) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2024-11-08 |