NPI | 1255716825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00883700) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066072) |
Enumeration Date | 2015-07-24 |
Last Update Date | 2025-04-24 |