NPI | 1215396353 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00830600) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 019442-1) |
Enumeration Date | 2016-02-17 |
Last Update Date | 2024-10-04 |