| NPI | 1386717775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00070400) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA MA000996L) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-05-28 |