| NPI | 1174870570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00292500) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055545) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2016-01-10 |