| NPI | 1578291472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00807800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008759) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2024-03-07 |