| NPI | 1952739518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13228) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00313900) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA10582) | |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2024-03-21 |