| NPI | 1972079440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00498800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060289) |
| 363A00000X Physician Assistant (Licence: PA OA004670) | |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2024-05-17 |