| NPI | 1437446234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 014827) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006872) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00274900) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2019-01-08 |