| NPI | 1467608133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 002669-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00141600) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |