| NPI | 1154861680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00589100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00589100) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA058874) | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2024-04-17 |