| NPI | 1043631831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00316100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017012-1) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2019-09-19 |