| NPI | 1063287894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00817100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031010) |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2023-11-26 |