| NPI | 1538693494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-920) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6073) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2019-10-11 |