| NPI | 1982831434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00281600) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2018-11-13 |