| NPI | 1497425904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027198) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA 1185508) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00629400) | |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |