| NPI | 1881970713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00240800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51271) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2016-02-05 |