| NPI | 1073055273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058728) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00420000) |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2023-11-06 |