| NPI | 1790113660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00319500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056466) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2025-10-13 |