| NPI | 1750717245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00472100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0167591) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2019-05-16 |