NPI | 1073159992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00748600) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026364-01) |
Enumeration Date | 2019-11-26 |
Last Update Date | 2023-02-01 |