| NPI | 1972748168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY MS1705384) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA056645) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00527200) | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2024-06-28 |