| NPI | 1366540221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25mp00164500) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2012-07-18 |