| NPI | 1790440295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00657500) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2024-08-21 |