| NPI | 1194969766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013089) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00215300) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2019-07-24 |