| NPI | 1558651240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00253300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054764) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2018-08-29 |