| NPI | 1346592318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-735) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004054) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2021-05-19 |