| NPI | 1740620343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00310000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066617) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2025-07-10 |