NPI | 1801415773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 10187) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2020-0076) |
363A00000X Physician Assistant | |
Enumeration Date | 2020-04-10 |
Last Update Date | 2024-07-19 |