| NPI | 1124563408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 020447) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020447) |
| 363AM0700X Physician Assistant, Medical (Licence: FL tppa557) | |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00677600) | |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2025-01-25 |