| NPI | 1881081636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001007297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00363500) |
| 363A00000X Physician Assistant (Licence: PA MA057528) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2020-10-21 |