| NPI | 1588700405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00202900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011176) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-06-15 |