| NPI | 1700447364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00523600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027789) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-05-27 |