| NPI | 1982030979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00850200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017053) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2024-10-01 |