| NPI | 1891886198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051747) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ MP00126200) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2018-01-26 |