| NPI | 1407005077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00257600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004963) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2017-06-06 |