| NPI | 1023434065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00326500) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 52050) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 017552) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2023-12-29 |