| NPI | 1720317654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00874900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010852) |
| 363A00000X Physician Assistant (Licence: PA MA062767) | |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2025-08-20 |