| NPI | 1487028312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA064249) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-1269-0) |
| 363AM0700X Physician Assistant, Medical (Licence: MA PA5588) | |
| 363AM0700X Physician Assistant, Medical (Licence: MT 53209) | |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2023-10-17 |