| NPI | 1497567283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA007160) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00900100) |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |