| NPI | 1811521974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: NJ 25MP00596900) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2021-01-14 |