| NPI | 1073110011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00785200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8506) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2024-03-21 |