| NPI | 1457998320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00548400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061236) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2021-08-25 |