| NPI | 1407087554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00250400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 20533) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2011-01-11 |