| NPI | 1174188379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00533600) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2023-09-26 |