| NPI | 1336180124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-676) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17341) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2021-07-09 |