| NPI | 1528373974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00238200) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2013-08-15 |