| NPI | 1417061870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00145300) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010698) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2012-10-02 |