NPI | 1760674667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00109700) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00109700) |
Enumeration Date | 2007-08-14 |
Last Update Date | 2020-06-15 |