| NPI | 1558349928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-693) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 003870) |
| 363AM0700X Physician Assistant, Medical (Licence: NV PA1089) | |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 4418) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2016-10-10 |