NPI | 1811745458 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 10391) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 10391) |
Enumeration Date | 2024-05-08 |
Last Update Date | 2025-06-25 |