| NPI | 1487174918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020894) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00444700) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-12-18 |