| NPI | 1831199264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00237500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03090) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2011-11-19 |