| NPI | 1568725174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25mp00317300) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015417) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2018-03-17 |