| NPI | 1407406234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00681300) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA004996) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA061026) | |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2022-05-05 |