| NPI | 1396150868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113404) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00348200) |
| 363A00000X Physician Assistant (Licence: NY 017738) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-04-02 |