| NPI | 1740256965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00161700) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000363) |
| 207T00000X Neurological Surgery (Licence: DE C5-0000363) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2011-01-10 |