| NPI | 1245204247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA002023L) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NJ MP20000) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2013-09-09 |