NPI | 1447794920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00419100) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17420) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA17420) | |
Enumeration Date | 2016-12-19 |
Last Update Date | 2024-11-11 |