| NPI | 1588376362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00819400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9098) |
| Enumeration Date | 2022-12-23 |
| Last Update Date | 2024-03-11 |