| NPI | 1851849830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00422900) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 020166) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2025-02-12 |