| NPI | 1124517750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00735400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059759) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2023-12-02 |