| NPI | 1760883284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA-057120) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006877) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00854700) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2026-03-05 |