| NPI | 1053562074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00194400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp0019440) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA320017L) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2023-12-04 |