NPI | 1043528086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00300200) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 007132) |
Enumeration Date | 2010-09-23 |
Last Update Date | 2025-03-10 |