| NPI | 1083234702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1309) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116126) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2025-07-01 |