| NPI | 1477706539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00208900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053702) |
| Enumeration Date | 2008-11-02 |
| Last Update Date | 2022-10-06 |