| NPI | 1699900985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-398) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60078086) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2021-06-02 |