| NPI | 1982950002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25mp00383500) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4441) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2018-06-19 |