| NPI | 1841688504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00799400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 018167-1) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2023-09-13 |