| NPI | 1619480365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00538200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065800) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2024-07-30 |