NPI | 1760886170 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00376100) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 018085) |
Enumeration Date | 2014-10-14 |
Last Update Date | 2019-10-10 |