| NPI | 1235493859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2764) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00328700) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2024-06-04 |