NPI | 1780154039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00494600) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00494600) |
363A00000X Physician Assistant | |
Enumeration Date | 2018-11-29 |
Last Update Date | 2024-08-20 |