| NPI | 1255369443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0711) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051169) |
| 363A00000X Physician Assistant (Licence: PA OA000785) | |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00100000) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-01-28 |