NPI | 1598284093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00707000) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059263) |
Enumeration Date | 2017-09-15 |
Last Update Date | 2022-11-03 |