| NPI | 1891289914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ MK6383513) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NJ MK6383513) |
| 363AS0400X Physician Assistant Surgical (Licence: NY 022081) | |
| 363A00000X Physician Assistant (Licence: NY 022081) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2024-03-05 |