NPI | 1285245811 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00567100) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00567100) |
Enumeration Date | 2020-08-17 |
Last Update Date | 2023-08-07 |