NPI | 1043069370 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00857100) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-05-17 |
Last Update Date | 2024-09-25 |