NPI | 1376918367 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00691300) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057925) |
Enumeration Date | 2015-12-02 |
Last Update Date | 2023-12-14 |