| NPI | 1992089452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014974-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00272500) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2012-05-15 |