NPI | 1396097853 |
---|---|
Former Name | VERONICA ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00207400) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00207400) |
Enumeration Date | 2012-10-09 |
Last Update Date | 2023-11-22 |