| NPI | 1851651889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00344000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014733-1) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2023-03-07 |