| NPI | 1023354016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20333) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00356700) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2024-11-19 |