| NPI | 1851565964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 0122111) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00260700) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2015-12-11 |