NPI | 1346411097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00208200) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MAO53235) |
Enumeration Date | 2008-03-20 |
Last Update Date | 2024-09-04 |