| NPI | 1336449354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00266400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010897-1) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2018-03-09 |