| NPI | 1598560252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00915800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 033284) |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-05-30 |