| NPI | 1093068538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13636) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113443) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00296100) | |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2023-12-06 |