| NPI | 1598355455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061955) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00602000) |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2022-04-01 |