| NPI | 1275130916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024506-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00581400) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |