| NPI | 1164965190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00479600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10914) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2023-01-23 |