| NPI | 1417348228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00359500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057444) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2019-09-04 |