| NPI | 1477911295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00475100) |
| 363A00000X Physician Assistant (Licence: PA OA003694) | |
| 363A00000X Physician Assistant (Licence: PA MA058005) | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2022-02-01 |