| NPI | 1972955474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 303099) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2021-08-10 |