| NPI | 1982365193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15013) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00694400) | |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2025-03-17 |