| NPI | 1699147363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00443500) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CT 3390) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2022-07-21 |