| NPI | 1710858030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MAO67125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00967900) |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-10-16 |