| NPI | 1083692073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00154700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052335) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2008-10-02 |