| NPI | 1740945401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00647800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062738) |
| Enumeration Date | 2021-11-07 |
| Last Update Date | 2022-05-04 |