NPI | 1811268527 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00272400) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 015028) |
Enumeration Date | 2012-01-26 |
Last Update Date | 2024-10-24 |