| NPI | 1700111598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 009890-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00118600) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2009-10-12 |