| NPI | 1083895601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA054165) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00189400) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2010-03-03 |