| NPI | 1467506139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110433) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00161000) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2018-01-17 |