| NPI | 1962803221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00392000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05211) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2023-04-27 |