NPI | 1134838337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00743700) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00743700) |
363A00000X Physician Assistant | |
Enumeration Date | 2022-11-16 |
Last Update Date | 2023-04-21 |