| NPI | 1417520628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00765400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2025-04-17 |