| NPI | 1891936779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00215100) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP 00215100) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 013140-1) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2019-11-06 |