| NPI | 1336607514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062834) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00515500) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2022-05-25 |