| NPI | 1356771935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00327500) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2021-11-01 |