NPI | 1073042693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00441200) |
Enumeration Date | 2017-06-07 |
Last Update Date | 2023-07-28 |