| NPI | 1295442176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064165) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00745300) |
| 363A00000X Physician Assistant (Licence: PA OA006046) | |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2023-08-27 |