| NPI | 1790148880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00967000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019535-1) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2025-11-04 |