| NPI | 1215728118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00934700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066652) |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-07-09 |