| NPI | 1730893496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10226) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1501-P.A) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2024-05-07 |