| NPI | 1295068492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013462-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP0041300) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2021-03-23 |