| NPI | 1588420343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 03124001) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00827500) |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-05-08 |