| NPI | 1023714771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA064235) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00744800) |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2023-02-03 |