| NPI | 1891199022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00348000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006229) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |