| NPI | 1336477124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00275100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054181) |
| 363A00000X Physician Assistant (Licence: CA 55960) | |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2024-08-15 |