| NPI | 1245400191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00195300) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012179-1) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2013-10-02 |