NPI | 1437756350 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00582100) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00582100) |
Enumeration Date | 2020-10-04 |
Last Update Date | 2021-07-27 |