| NPI | 1942585328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00432700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015220) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2023-03-08 |