| NPI | 1760717599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00785900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 0135921) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2025-05-14 |