| NPI | 1952665606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00463900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015505) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2025-08-21 |