| NPI | 1811329964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016720-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00352808) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2021-05-10 |