| NPI | 1710382833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00401900) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2022-08-29 |