| NPI | 1578988838 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00326100) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA65031) | 
| 363AM0700X Physician Assistant, Medical (Licence: WA PA61387790) | |
| Enumeration Date | 2014-02-24 | 
| Last Update Date | 2025-10-09 |