| NPI | 1861547564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA007173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00093200) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-02-25 |