| NPI | 1992177182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56966) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00381400) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2020-02-12 |