NPI | 1184758096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6589) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ MP00509) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2022-01-07 |