NPI | 1346559374 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00280700) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013366-1) |
363A00000X Physician Assistant (Licence: IL 085003663) | |
Enumeration Date | 2010-09-24 |
Last Update Date | 2024-05-28 |