| NPI | 1134674377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00390400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 019401) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-08-17 |