| NPI | 1164725743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00357400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA1094917) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00357400) | |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2020-06-15 |