| NPI | 1689891574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00462600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052284) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2025-03-17 |