NPI | 1710218292 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00245100) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 2371) |
Enumeration Date | 2010-01-22 |
Last Update Date | 2019-09-23 |