| NPI | 1194865071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00145000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010744) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2009-04-27 |