| NPI | 1134277767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031624) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0115381) |
| 363A00000X Physician Assistant (Licence: CA 52139) | |
| 363A00000X Physician Assistant (Licence: NJ 25MP00420100) | |
| 363A00000X Physician Assistant (Licence: PA MA058499) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-10-28 |