| NPI | 1669759338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00295900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002669) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2016-08-23 |