| NPI | 1164298014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00816000) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MP00816000) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2024-07-25 |