NPI | 1144896572 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00644600) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 026673) |
Enumeration Date | 2021-05-27 |
Last Update Date | 2023-12-22 |