| NPI | 1396931119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00198400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104353) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2010-07-07 |