NPI | 1184803488 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00304100) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2007-11-02 |
Last Update Date | 2018-09-04 |