| NPI | 1205651684 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00901600) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2024-11-20 | 
| Last Update Date | 2025-01-10 |