| NPI | 1780840074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00540800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012189) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2020-08-06 |