| NPI | 1508262783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00397000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108240) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2019-11-13 |