| NPI | 1881654614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA050682) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00365500) |
| 207Q00000X Family Medicine (Licence: PA MA050628-L) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-01-28 |