| NPI | 1699317958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-1267) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2024-08-29 |