| NPI | 1609217462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD890) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00308900) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2019-08-14 |