| NPI | 1881973287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055684) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00262600) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA002908) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2013-02-18 |