| NPI | 1528820529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00845300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1219173) |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-10-10 |