| NPI | 1578288619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011816) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00796600) |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2024-01-14 |