| 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 |