| NPI | 1649356619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA15461) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25mp00132700) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 010032) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2023-07-11 |