| NPI | 1700648367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00960500) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 031136) | |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2025-09-26 |