| NPI | 1386214781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00818200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115141) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2024-09-24 |