| NPI | 1023483609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00703700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019024) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2025-02-14 |