| NPI | 1700036811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00223500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104724) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2011-02-02 |