| NPI | 1154295491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA067090) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00966000) |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |