NPI | 1306321708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00943100) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062334) |
Enumeration Date | 2018-10-01 |
Last Update Date | 2025-08-21 |