| NPI | 1417131327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012333-1) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00193000) | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2023-10-03 |