| NPI | 1225745300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00731700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 029098-01) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00731700) | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2024-07-03 |