| NPI | 1831466481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055236) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110518) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00289900) | |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2019-02-05 |