NPI | 1073200549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00783500) |
Enumeration Date | 2023-04-24 |
Last Update Date | 2023-06-26 |