| NPI | 1972088490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060381) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00487900) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2019-07-19 |