| NPI | 1609559186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012258) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00888800) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2026-04-10 |