| NPI | 1366106031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00841900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063095) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2024-11-13 |