| NPI | 1205180700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015651) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00287700) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2016-05-31 |