| NPI | 1255332474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00017800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005217-1) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2018-06-20 |