NPI | 1962558585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00235700) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 2205) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2024-07-23 |