| NPI | 1861099145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00584800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025675-01) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2025-04-04 |