| NPI | 1477230308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00876300) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 030278) |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2024-10-23 |