| NPI | 1972078103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00498100) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0001262) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2024-04-09 |