| NPI | 1831497452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054749) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00251600) |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2013-01-25 |