| NPI | 1568630721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00674700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0119051) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2023-12-13 |