| NPI | 1821406513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00341900) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058158) |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2016-10-25 |