| NPI | 1376094805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115055) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp00413100) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2024-09-20 |