| NPI | 1720548753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NV PA2103) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 7395) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2021-05-18 |