| NPI | 1558766014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11107779-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP003503000) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2024-01-10 |