| NPI | 1467943381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00622000) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2021-09-22 |