NPI | 1235434689 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA51369) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00251300) |
Enumeration Date | 2011-01-17 |
Last Update Date | 2023-04-19 |