| NPI | 1548354491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052181) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp00134100) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2019-11-22 |