| NPI | 1043508955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-716) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014866) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2021-06-15 |