| NPI | 1013422856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059548) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004390) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00457000) | |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2024-01-18 |