| NPI | 1588037725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00543900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019337) |
| 363A00000X Physician Assistant (Licence: MA PA5984) | |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2020-09-03 |