| NPI | 1598895385 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA182946) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-294) | 
| Enumeration Date | 2007-03-07 | 
| Last Update Date | 2025-02-24 |