| NPI | 1114611936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00960200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA064860) |
| 363A00000X Physician Assistant (Licence: PA MA064860) | |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2025-11-13 |