| NPI | 1346411097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00208200) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MAO53235) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2023-12-22 |