| NPI | 1811268527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00272400) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 015028) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2021-04-12 |