NPI | 1255843405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00730000) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021604) |
Enumeration Date | 2017-10-27 |
Last Update Date | 2023-08-04 |