| NPI | 1235103326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0010105) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ MP00663) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2025-08-26 |