NPI | 1013627462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011847) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00740800) |
Enumeration Date | 2022-11-28 |
Last Update Date | 2022-11-28 |