| NPI | 1710471982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25mp00476300) |
| 363A00000X Physician Assistant (Licence: PA MA059826) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2025-07-21 |