| NPI | 1790495927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9695) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA62006) |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2023-06-13 |