| NPI | 1215457940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020944-1) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NJ 25MP00439500) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-09-21 |