| NPI | 1427350982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00678400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 014493) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2022-12-01 |