| NPI | 1235864133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1539) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 65498) |
| 363A00000X Physician Assistant (Licence: SC 5018) | |
| Enumeration Date | 2022-07-24 |
| Last Update Date | 2026-09-12 |