| NPI | 1952829582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2666) |
| Enumeration Date | 2017-09-04 |
| Last Update Date | 2023-12-12 |