| NPI | 1801090253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25mp00184500) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL pa9105002) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-03-25 |