| NPI | 1780816637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00254200) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 013409) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2018-02-14 |