| NPI | 1811394984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00527700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018260) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2022-11-03 |