| NPI | 1710684592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00885100) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 9118030) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2025-05-21 |