| NPI | 1013310473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25mp00519300) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C05509) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2023-11-29 |