| NPI | 1003188293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015186) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 24MP00269800) |
| 363A00000X Physician Assistant (Licence: PA OA002729) | |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2022-07-21 |