| NPI | 1073728093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00251200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008872) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 008872) | |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2021-02-09 |