| NPI | 1316247224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4440) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00246100) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2023-03-07 |