| NPI | 1568501104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00701200) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 007257) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2022-07-27 |