| NPI | 1134904816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00789900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030471) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2023-08-30 |