| NPI | 1003499575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 59497) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp00970200) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2025-11-12 |