| NPI | 1790258614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7380) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004793) |
| 363A00000X Physician Assistant (Licence: PA MA060564) | |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2024-03-14 |