NPI | 1427686674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00671900) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-31 |
Last Update Date | 2022-10-13 |