NPI | 1033879143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00678700) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-12-30 |
Last Update Date | 2022-01-31 |