| NPI | 1811367949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00696800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019018) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2026-01-22 |