| NPI | 1912316654 |
|---|---|
| Former Name | JEANNA HANAKO TACHIKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207N00000X Dermatology (Licence: UT 87742931206) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2021-11-17 |