| NPI | 1982341624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 028061) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00690900) | |
| Enumeration Date | 2022-05-15 |
| Last Update Date | 2022-05-15 |