| NPI | 1649640541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00387800) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057900) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2021-05-26 |