| NPI | 1730764663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063563) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00598000) |
| 363A00000X Physician Assistant (Licence: PA OA006097) | |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2022-08-16 |