| NPI | 1215943311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00218600) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 008800) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-03-04 |