| NPI | 1942637103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 5493) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5493) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 016897-1) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2025-06-25 |