| NPI | 1548372931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00191000) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 001161) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-12-20 |