| NPI | 1053793505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00387400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 018665) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2022-04-19 |