NPI | 1184192734 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00502800) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-11-12 |
Last Update Date | 2019-04-15 |