| NPI | 1306937776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 005254) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ mp00154900) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00154900) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2023-06-30 |