| NPI | 1306553144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00912600) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 6137) |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2025-03-17 |