| NPI | 1083893119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00185900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011098-1) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2015-01-12 |