| NPI | 1396255147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113779) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021498) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00449600) | |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2021-04-13 |