| NPI | 1720268618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2740) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA189433) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2025-11-19 |