| NPI | 1689785156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 003633) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002105) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00335300) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-04-11 |