| NPI | 1407815806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: PA MA051870) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MPOO136700) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-05-05 |