| NPI | 1396259958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111444) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00455800) |
| Enumeration Date | 2017-11-18 |
| Last Update Date | 2021-09-07 |