| NPI | 1922278696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7447) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53818) |
| Enumeration Date | 2008-03-09 |
| Last Update Date | 2021-07-28 |