| NPI | 1184067332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00677000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 51966) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 5078) | |
| 363A00000X Physician Assistant (Licence: CT 5078) | |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 5403) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2022-03-30 |