NPI | 1447891379 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00544100) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-10-02 |
Last Update Date | 2024-05-10 |