| NPI | 1245611144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00675500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0186021) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2025-01-28 |