| NPI | 1619628351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00670600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063293) |
| 363A00000X Physician Assistant (Licence: PA OA005970) | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |