| NPI | 1477616944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012579-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 001204) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00191900) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2017-02-17 |