NPI | 1356757868 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00690400) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017692) |
208600000X Surgery (Licence: NY 017692) | |
Enumeration Date | 2014-07-03 |
Last Update Date | 2024-04-18 |