| NPI | 1558455055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA003152L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00059700) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2009-05-11 |