| NPI | 1083303366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00852800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2023037847) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2025-02-21 |