| NPI | 1700133832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00288800) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2024-03-25 |