| NPI | 1306433305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00615300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025991) |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2025-01-23 |