NPI | 1629728076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00741900) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00741900) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-28 |
Last Update Date | 2022-12-16 |