| NPI | 1356913883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00643200) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 1172590) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-12-22 |