| NPI | 1003315714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp0043000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00430000) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2023-07-04 |