| NPI | 1922167550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1025) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9101480) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2022-07-25 |