| NPI | 1881213247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ NJDCATEMP-006503) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ NJDCATEMP-006489) |
| 363A00000X Physician Assistant (Licence: PR 000288-PA) | |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |