NPI | 1245204247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA002023L) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ MP20000) |
Enumeration Date | 2006-02-15 |
Last Update Date | 2013-09-09 |