| NPI | 1306667795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032821) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00883900) |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2024-11-05 |