| NPI | 1184192734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00502800) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2019-04-15 |