NPI | 1316352768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00336800) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058408) |
Enumeration Date | 2014-06-24 |
Last Update Date | 2021-05-24 |