| NPI | 1457632812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00797200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015131) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2025-02-18 |