NPI | 1598172801 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 017699-1) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3137) |
363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00344500) | |
Enumeration Date | 2014-07-18 |
Last Update Date | 2018-03-17 |