| NPI | 1538678305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00524300) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 021736) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2023-09-18 |