| NPI | 1710109392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00168300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 25mp00168300) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2017-07-12 |