| NPI | 1417328311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057786) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003613) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00377900) | |
| Enumeration Date | 2015-10-18 |
| Last Update Date | 2016-07-19 |