| NPI | 1760777858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060978) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00346900) |
| 363A00000X Physician Assistant (Licence: NY 014805-1) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2019-10-14 |