| NPI | 1740819168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00562600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024814) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |