| NPI | 1942663992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00607300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019611) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-07-24 |