| NPI | 1710218292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00245100) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 2371) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2019-09-23 |