| NPI | 1407668114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00817600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 032220) |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-02-26 |