| NPI | 1821436593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00419800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107250) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2018-07-19 |