| NPI | 1568901007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00778500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020617) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2024-12-02 |