| NPI | 1861612988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00001900) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00001900) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA001316L) | |
| 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000436) | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2025-04-08 |