NPI | 1538678305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00524300) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 021736) |
Enumeration Date | 2017-09-25 |
Last Update Date | 2023-09-18 |