| NPI | 1659621704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00292900) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2024-10-31 |