| NPI | 1770761702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00185300) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2014-12-06 |