| NPI | 1619983640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00000600) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 001624-1) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-06-25 |