NPI | 1356995245 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001326) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001326) |
363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00536300) | |
Enumeration Date | 2019-07-29 |
Last Update Date | 2024-09-13 |