| NPI | 1316227481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25mp00261600) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2019-10-02 |