| NPI | 1639393291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002140) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00072700) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00072700) | |
| 363AM0700X Physician Assistant, Medical (Licence: CT 002140) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2009-03-17 |