NPI | 1043683626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00092800) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00092800) |
Enumeration Date | 2015-11-04 |
Last Update Date | 2025-08-18 |