| NPI | 1639575095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-965) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018205-1) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2021-06-09 |