NPI | 1346481983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3315) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00213100) |
363A00000X Physician Assistant (Licence: CT 3315) | |
Enumeration Date | 2009-03-11 |
Last Update Date | 2022-11-25 |