| NPI | 1053546408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00519400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6937) |
| 363A00000X Physician Assistant (Licence: VA 0110840819) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2019-05-28 |