| NPI | 1811703200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00901800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 033024) |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2026-04-15 |