| NPI | 1144871674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00684100) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2022-10-13 |