| NPI | 1255621074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00546500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA003088L) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2024-09-18 |