| NPI | 1750364626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD 160) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-160) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2025-07-23 |