| NPI | 1780818724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00216900) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2014-02-19 |