| NPI | 1811597305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00586800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007122) |
| 363A00000X Physician Assistant (Licence: PA MA062201) | |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2024-12-03 |