| NPI | 1336915727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00894700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031424) |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2025-01-20 |