NPI | 1376027888 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA061369) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00495100) |
Enumeration Date | 2018-09-20 |
Last Update Date | 2023-04-04 |