| NPI | 1194048728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA61510) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00234700) |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2024-08-13 |