| NPI | 1275043705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00463000) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA059371) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2022-06-15 |