| NPI | 1154615540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00422000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY P80001) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2020-02-21 |