| NPI | 1558451336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052561) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00140000) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-11-26 |