| NPI | 1104009273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00184300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA001918L) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2015-06-12 |