| NPI | 1225400849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00382900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0188941) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-11-06 |