| NPI | 1801330030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020299) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NJ 25MP00822400) | |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2024-12-23 |