NPI | 1184913683 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00117400) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 002720) |
Enumeration Date | 2011-04-05 |
Last Update Date | 2024-02-28 |