| NPI | 1942724844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5704) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00439300) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-04-05 |