| NPI | 1649678046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00355400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057265) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2020-02-12 |