NPI | 1376841825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053688) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00223300) |
Enumeration Date | 2011-03-08 |
Last Update Date | 2023-01-12 |