| NPI | 1568077063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025482) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00577100) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2022-10-10 |