| NPI | 1861556391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 19054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-62) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-12-07 |