| NPI | 1720624042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10156) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002869A) |
| 363A00000X Physician Assistant (Licence: OR PA213392) | |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2024-03-18 |