| NPI | 1063970085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 36790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023238-1) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2022-04-30 |