| NPI | 1225197486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00172000) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: IL 085.003255) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2022-05-03 |