| NPI | 1265679708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00187800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011406) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2011-08-02 |