| NPI | 1427132018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NY 009460) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 009460) |
| 363A00000X Physician Assistant (Licence: NY 009460) | |
| 363A00000X Physician Assistant (Licence: NJ MP00119600) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |