| NPI | 1962387720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 7205) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00944200) |
| Enumeration Date | 2025-08-09 |
| Last Update Date | 2025-08-09 |