| NPI | 1558766014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11107779-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 11107779-1206) |
| 363A00000X Physician Assistant (Licence: NJ 25MP003503000) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2026-03-24 |