| NPI | 1225515554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00666900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6662) |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2024-02-14 |