NPI | 1932864253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP0067900) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2021-11-02 |
Last Update Date | 2022-01-26 |