| NPI | 1306097852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00207200) |
| 363A00000X Physician Assistant (Licence: PA MA053650) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2023-10-30 |