NPI | 1316282668 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00059800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002357L) |
Enumeration Date | 2012-11-27 |
Last Update Date | 2012-11-27 |