| NPI | 1326098799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA051126) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00161300) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-10-22 |