| NPI | 1417257858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 00241500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA ma054346) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2011-12-06 |