| NPI | 1093323768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00576500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061703) |
| 363A00000X Physician Assistant (Licence: PA OA005300) | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2023-04-17 |