| NPI | 1174092837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1684) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MP00500000) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 4341) | |
| Enumeration Date | 2018-11-24 |
| Last Update Date | 2026-05-04 |