| NPI | 1841622743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00654500) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 016787) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2022-06-16 |