| NPI | 1013248095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00232800) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA054241) | |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2021-04-01 |