| NPI | 1184095689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00582900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019044) |
| 363A00000X Physician Assistant (Licence: TX PA13039) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2021-10-22 |