| NPI | 1164633566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052944) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ MA052944) |
| 363A00000X Physician Assistant (Licence: NY 011507-1) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2018-08-02 |