| NPI | 1558606954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00306000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015842) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2015-06-20 |