| NPI | 1023181252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00059000) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NJ 25MP00059000) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |