| NPI | 1184929531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9111142) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00249300) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-04275) | |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2019-08-06 |