| NPI | 1508619438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031678) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00839600) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-04-10 |