| NPI | 1003826157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ MP00136000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010318) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2014-06-17 |