NPI | 1295389856 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00541500) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2019-07-31 |
Last Update Date | 2025-06-16 |