| NPI | 1992172969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00371500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022033) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2024-02-28 |