| NPI | 1578905352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00312300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00312300) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2018-03-17 |