| NPI | 1336732957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00596500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062346) |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2021-07-07 |