| NPI | 1861941874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00655300) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA5818) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2024-10-24 |