| NPI | 1750698403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-385) |
| 363A00000X Physician Assistant (Licence: NY 016427) | |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2015-04-02 |