| NPI | 1366066474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064177) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NJ MP00597600) | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2023-02-02 |