| NPI | 1003410358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1377) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10986) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2025-07-07 |