| NPI | 1912482282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112376) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MP00496700) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2020-06-10 |