| NPI | 1609155977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055676) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008014) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00257500) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2024-04-09 |