| NPI | 1871573808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2168) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA889) |
| 363A00000X Physician Assistant (Licence: CA PA51514) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-03-04 |