| NPI | 1932486743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015115-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00271700) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2016-08-30 |