| NPI | 1265688337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA21069) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00202000) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2022-05-03 |