| NPI | 1639245178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00256400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011495) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2019-05-16 |