NPI | 1275006579 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00503800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00503800) |
Enumeration Date | 2019-01-09 |
Last Update Date | 2024-12-09 |