| NPI | 1669466298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00165100) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9102887) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2023-11-28 |