| NPI | 1619150448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00198700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012293) |
| Enumeration Date | 2007-12-15 |
| Last Update Date | 2010-09-29 |