| NPI | 1215278890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22793) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2021-06-15 |