| NPI | 1144418054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 028248) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053102) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00228600) | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2022-09-07 |