| NPI | 1568943058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00496000) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 022526) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2020-11-10 |