| NPI | 1962868596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1701) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2021-12-20 |