| NPI | 1043609910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00431600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018347) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2022-08-03 |