| NPI | 1760646012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00135700) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA-002400L) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-04-27 |