| NPI | 1487119186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00734800) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA060310) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA060310) | |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2023-12-02 |