| NPI | 1326489477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00311200) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA056182) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA OA003062) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2023-08-08 |