| NPI | 1962014621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00701500) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00701500) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA061907) | |
| Enumeration Date | 2020-08-23 |
| Last Update Date | 2024-05-28 |