| NPI | 1104468651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00558600) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2020-09-22 |