| NPI | 1891990180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1152) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19095) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-09-06 |