| NPI | 1558838060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00484800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022566) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-07 |