NPI | 1356487581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00169100) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00169100) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2024-05-15 |