| NPI | 1114166980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010202) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00215400) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2015-03-30 |