| NPI | 1740808823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061767) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00579400) | |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2024-04-24 |