| NPI | 1669972477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00511400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059678) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2021-02-17 |