NPI | 1457878944 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00721100) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 021542) |
Enumeration Date | 2017-08-24 |
Last Update Date | 2025-03-27 |