| NPI | 1356777353 |
|---|---|
| Former Name | THERESA ANN DIJOSEPH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056359) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00347500) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2019-09-10 |