| NPI | 1942839592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1254) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-05-04 |