| NPI | 1518143767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00263300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053319) |
| 363AM0700X Physician Assistant, Medical (Licence: DE C50000623) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2021-05-12 |