| NPI | 1154637841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00963200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014186) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2025-09-16 |