| NPI | 1821507096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00473300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021666) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2023-09-22 |