NPI | 1275916082 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00587600) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-06-30 |
Last Update Date | 2023-01-23 |