| NPI | 1497037634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111449) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00377300) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2018-11-30 |