| NPI | 1205376597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020588) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00424500) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |