| NPI | 1366894198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00564600) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 003741) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2020-09-04 |