| NPI | 1851689061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015895-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00260000) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2012-09-30 |