| NPI | 1295069664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0844) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00226200) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2020-08-18 |