| NPI | 1366917338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00522700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE Pending) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2019-06-26 |