NPI | 1306064357 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00144300) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00144300) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2024-08-01 |