NPI | 1205598067 |
---|---|
Former Name | SARAH ROSE EVENOSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00643900) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MP00643900) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MP00643900) | |
Enumeration Date | 2021-10-08 |
Last Update Date | 2024-10-28 |