| NPI | 1427376342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00465900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105022) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2018-08-23 |