| NPI | 1841626322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6007) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006796) |
| 363A00000X Physician Assistant (Licence: CA 59135) | |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2023-10-06 |