| NPI | 1255159604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00877200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 032261) |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-02 |