| NPI | 1366658478 |
|---|---|
| Former Name | MICHELE LYNNE DEOLIVEIRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00148300) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-08-25 |