| NPI | 1942455621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00210400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053699) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |