| NPI | 1932578689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00413000) |
| 363A00000X Physician Assistant (Licence: MD C0005871) | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2020-09-11 |