| NPI | 1043971104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00931400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027984) |
| Enumeration Date | 2021-12-31 |
| Last Update Date | 2026-01-16 |