| NPI | 1134455132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25mp00228400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013806) |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2015-12-02 |