| NPI | 1629178900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105218) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00030500) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-10-16 |