| NPI | 1093575680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00842800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031697) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-08-28 |