| NPI | 1164766192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00430200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055853) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-05-17 |