NPI | 1336141753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00209800) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA050743) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2024-08-08 |