| NPI | 1356757868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00690400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017692) |
| 208600000X Surgery (Licence: NY 017692) | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2024-04-18 |