NPI | 1922172121 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00463) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00163000) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2011-07-22 |