| NPI | 1962785212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1295) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-617) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2022-02-22 |