| NPI | 1013380393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10747) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00502100) |
| 363AM0700X Physician Assistant, Medical (Licence: NH 1132) | |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2024-04-24 |