| NPI | 1205261641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00664900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY P87315) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2023-11-29 |