| NPI | 1003221193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00348900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017609) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2019-07-05 |