| NPI | 1992754683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00117000) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA051086) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-12-02 |