| NPI | 1669667341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA05311) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00279900) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA053181) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2017-12-07 |