| NPI | 1245435148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2397) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00303200) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-02-27 |