| NPI | 1790950806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22328) |
| 363A00000X Physician Assistant (Licence: HI AMD-519) | |
| 363A00000X Physician Assistant (Licence: IL 085-001099) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2021-12-30 |