NPI | 1295442176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064165) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00745300) |
363A00000X Physician Assistant (Licence: PA OA006046) | |
Enumeration Date | 2022-11-01 |
Last Update Date | 2023-08-27 |