| NPI | 1548711856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00665400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020364) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00665400) | |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2024-07-29 |