| NPI | 1750103479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00947700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0012164) |
| Enumeration Date | 2024-10-25 |
| Last Update Date | 2025-09-10 |