| NPI | 1881708006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103441) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00131400) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2010-10-13 |