| NPI | 1508258831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00360100) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: PA DN004955) |
| 363A00000X Physician Assistant (Licence: PA MA057458) | |
| 363A00000X Physician Assistant (Licence: NJ 25MP00360100) | |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2020-10-22 |