NPI | 1184377491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00843900) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00842900) |
Enumeration Date | 2022-01-27 |
Last Update Date | 2024-07-03 |