| NPI | 1740777127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00681000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55580) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2022-12-17 |