| NPI | 1750469979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052296) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000958) |
| 363A00000X Physician Assistant (Licence: OH 50.005099RX) | |
| 363A00000X Physician Assistant (Licence: NJ 25MP00605600) | |
| 363A00000X Physician Assistant (Licence: NY 024720) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-05-21 |