| NPI | 1891834024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00214300) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010154-1) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2015-06-03 |