| NPI | 1841536778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00464100) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004942) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA056127) | |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2020-04-17 |