| NPI | 1619713542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00982900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007552) |
| 363A00000X Physician Assistant (Licence: PA MA067394) | |
| 363A00000X Physician Assistant (Licence: NY 035616-01) | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2026-05-13 |