| NPI | 1821065236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: HI AMD-154) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 14883) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2012-05-03 |