NPI | 1295353316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00706300) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-07-07 |
Last Update Date | 2024-08-26 |