| NPI | 1023410016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00575000) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 017958-1) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2021-02-04 |