NPI | 1306454632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00579600) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 02521501) |
Enumeration Date | 2020-07-22 |
Last Update Date | 2023-10-30 |