| NPI | 1780819763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00389200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002204L) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2022-01-13 |