| NPI | 1497908248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-504) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053666) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2015-08-08 |