| NPI | 1750707709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00332500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017294) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2016-12-15 |