| NPI | 1730376963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00198500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012066) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2017-03-14 |