| NPI | 1215262118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA53317) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00223100) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2018-11-16 |