| NPI | 1588098909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-752) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54117) |
| 363A00000X Physician Assistant (Licence: WA 60921045) | |
| 363A00000X Physician Assistant (Licence: NY 018293) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2021-03-16 |