| NPI | 1407407729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00537500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023920) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |