| NPI | 1295187839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00806500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024314) |
| 363A00000X Physician Assistant (Licence: VA 0110-005416) | |
| 363A00000X Physician Assistant (Licence: MI 5601012407) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2024-05-07 |