| NPI | 1790368009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062183) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0007808) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 58994) | |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00595100) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2023-11-29 |