| NPI | 1063068823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ 25MP00537600) |
| 208200000X Plastic Surgery (Licence: NJ 25MP00537600) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NJ 25MP00537600) | |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2024-06-20 |