| NPI | 1255765533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00312400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016699-1) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25mp00312400) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2025-03-31 |