NPI | 1154042794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00705300) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MP00705300) |
Enumeration Date | 2022-09-12 |
Last Update Date | 2023-05-05 |