NPI | 1326348723 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00250500) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054599) |
Enumeration Date | 2010-11-01 |
Last Update Date | 2017-07-28 |