NPI | 1043707276 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00504000) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C110000025) |
363AM0700X Physician Assistant, Medical (Licence: PA MA059701) | |
207QA0505X Family Medicine, Adult Medicine (Licence: PA OA004442) | |
Enumeration Date | 2018-04-13 |
Last Update Date | 2025-09-19 |