| NPI | 1003537259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00726500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063706) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-04-18 |