| NPI | 1518749092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00812900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030723) |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2023-12-27 |