| NPI | 1427625474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1062) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: HI DH-1672) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2022-03-22 |