NPI | 1942826458 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00582200) |
Additional Taxonomies | 363A00000X Physician Assistant |
208600000X Surgery (Licence: NJ 25MP00582200) | |
Enumeration Date | 2020-06-20 |
Last Update Date | 2020-10-09 |