| NPI | 1649607284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00544000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003112) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA056344) | |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2024-08-08 |