| NPI | 1366744989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC TL2265) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00248200) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2020-12-15 |