| NPI | 1194946772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010297-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00141200) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-06-20 |