| NPI | 1447431457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056227) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012238) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00233400) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2016-01-12 |