| NPI | 1750710315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056503) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00317800) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2015-06-05 |