| NPI | 1366119612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00862100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062680) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2025-03-31 |