| NPI | 1639990971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00890800) |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-11-22 |