| NPI | 1225698202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00645300) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2022-09-29 |