| NPI | 1134527682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061734) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00354200) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2022-01-27 |