| NPI | 1639208168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2586) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00143900) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2022-08-12 |