NPI | 1164160065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00713900) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-05-22 |
Last Update Date | 2024-02-13 |