| NPI | 1063882231 |
|---|---|
| Former Name | EDELMIRA APRIL TIMMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00378900) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NJ 25 MP00378900) |
| 363AM0700X Physician Assistant Medical (Licence: VA 0110- 004962) | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2022-07-14 |