| NPI | 1194367847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00659900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060968) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2024-10-08 |