| NPI | 1205238276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00344400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057153) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2016-06-02 |