| NPI | 1720486921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017986) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00349900) |
| Enumeration Date | 2014-12-21 |
| Last Update Date | 2019-05-02 |