| NPI | 1417333410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00598200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00598200) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 3862) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2021-03-08 |