| NPI | 1285236117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00607800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00607800) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2023-11-06 |