| NPI | 1558722322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021118) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00391900) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2019-07-24 |