| NPI | 1609159334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00267100) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 0150631) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2012-03-30 |