| NPI | 1881086460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00365200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53355) |
| 363A00000X Physician Assistant (Licence: PA MA057464) | |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2022-11-17 |