| NPI | 1740661131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00498000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057585) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2024-11-14 |