| NPI | 1154672749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021006-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00444800) |
| 225100000X Physical Therapist (Licence: NJ 40QA01466200) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2018-03-17 |