| NPI | 1780337196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00698400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063359) |
| 363A00000X Physician Assistant (Licence: PA OA006011) | |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2023-03-07 |