| NPI | 1073850178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-487) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA-12486) |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2013-01-09 |