| NPI | 1740529072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00301800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110006645) |
| 363A00000X Physician Assistant (Licence: CT 003061) | |
| 363A00000X Physician Assistant (Licence: VA 0110006645) | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2024-07-04 |