| NPI | 1851736284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00848600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 8613) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 016361) | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2025-10-21 |