| NPI | 1750591293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 007983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00121800) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2014-01-08 |