| NPI | 1073508826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00529200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA3146) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2022-09-08 |