NPI | 1255099446 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00815600) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063274) |
Enumeration Date | 2021-12-04 |
Last Update Date | 2025-06-03 |