| NPI | 1578829560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00625900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014304) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-01-30 |