| NPI | 1447792825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9113252) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00414900) |
| 363A00000X Physician Assistant (Licence: NY 020311-1) | |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2020-09-24 |