| NPI | 1356762082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060551) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp00324800) |
| 363A00000X Physician Assistant (Licence: NY 017272) | |
| Enumeration Date | 2013-12-24 |
| Last Update Date | 2019-07-23 |