| NPI | 1013064203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00395700) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010605) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-12-15 |