| NPI | 1801504477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA064842) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00659800) |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2024-12-17 |