NPI | 1043339757 |
---|---|
Former Name | ALYSSA SHERIDAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00110200) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00110200) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2025-02-14 |