| NPI | 1235147190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 009135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp00187500) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-05-22 |