NPI | 1194378455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032868) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MP00533500) |
Enumeration Date | 2019-07-16 |
Last Update Date | 2024-12-23 |