| NPI | 1932689486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00488800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00488800) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2023-06-09 |