| NPI | 1669046314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00622300) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2026-07-11 |