| NPI | 1235698333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00673100) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2021-12-15 |