NPI | 1285514190 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA007396) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00964800) |
363A00000X Physician Assistant (Licence: PA MA066964) | |
Enumeration Date | 2025-09-03 |
Last Update Date | 2025-09-15 |