| NPI | 1740321207 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5333) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C03462) | 
| Enumeration Date | 2007-02-09 | 
| Last Update Date | 2024-10-31 |