| NPI | 1174854285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054199) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00230300) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2015-05-29 |