| NPI | 1962885301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00337000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018253-1) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |