| NPI | 1003065046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00553400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012760) |
| 363A00000X Physician Assistant (Licence: GA 5984) | |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2024-05-14 |