| NPI | 1376678565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-512) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56372) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-10-13 |