| NPI | 1386834109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00260400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002840L) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2020-12-15 |