| NPI | 1801667712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00836300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065244) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2025-07-07 |