| NPI | 1073241642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 029835) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00772900) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-06-03 |