| NPI | 1104202654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057701) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00373800) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2024-08-14 |