| NPI | 1669832150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00630300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024962) |
| 363A00000X Physician Assistant (Licence: MS PA00282) | |
| 363A00000X Physician Assistant (Licence: OH 50.004776RX) | |
| 363A00000X Physician Assistant (Licence: MI 5601009916) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2024-03-21 |