| NPI | 1043707276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00504000) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: PA OA004442) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2021-01-14 |