| NPI | 1609073634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00325400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052614) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-09-20 |