| NPI | 1548480452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00130100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0102371) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2007-07-08 |