| NPI | 1114222940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00245800) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 0010-08477) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2019-01-17 |