| NPI | 1790399483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00614400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9113364) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2021-08-09 |