| NPI | 1760631279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00879200) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2024-09-17 |