NPI | 1386834109 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00260400) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002840L) |
Enumeration Date | 2007-07-27 |
Last Update Date | 2020-12-15 |