| NPI | 1700862208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00074900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ mp000749) |
| 363AM0700X Physician Assistant, Medical (Licence: MD C01976) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA002636L) | |
| 363AM0700X Physician Assistant, Medical (Licence: DE C50000214) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2025-03-10 |