NPI | 1366171340 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00843800) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 030260) |
Enumeration Date | 2022-06-06 |
Last Update Date | 2024-11-13 |