| NPI | 1144951492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00807400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 030662) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2023-12-20 |