| NPI | 1952630964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013372-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00222000) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2016-03-10 |