| NPI | 1942389960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010833) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00292700) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-04-05 |