| NPI | 1932841947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9391) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8791) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2024-04-11 |