| NPI | 1316451172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00460700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059525) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2024-10-28 |