| NPI | 1356615835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00318300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03424) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-03424) | |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2015-06-18 |