| NPI | 1235828971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064947) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00936900) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2025-11-05 |