| NPI | 1245882968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00574100) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4510) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2021-07-23 |