| NPI | 1457374639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00132100) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA MA051861) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-02-27 |