NPI | 1265082101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00587100) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-09-12 |
Last Update Date | 2022-01-18 |