| NPI | 1609229715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109651) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00819700) |
| 363A00000X Physician Assistant (Licence: CA 66168) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2026-05-18 |