NPI | 1386195147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006661) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058427) |
363A00000X Physician Assistant (Licence: NJ 25MP00403200) | |
Enumeration Date | 2016-10-17 |
Last Update Date | 2025-04-23 |