| NPI | 1376373100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031946) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00866900) |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2025-01-23 |