| NPI | 1972159689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00699800) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: PA OA004938) |
| 363A00000X Physician Assistant (Licence: PA OA004938) | |
| 363A00000X Physician Assistant (Licence: PA MA060823) | |
| Enumeration Date | 2019-08-18 |
| Last Update Date | 2022-05-02 |