| NPI | 1669791802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20948) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NJ 25MP00358600) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2024-06-10 |