| NPI | 1871125641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1271-0) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9581) |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2024-01-28 |