NPI | 1457998320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00548400) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061236) |
Enumeration Date | 2019-12-10 |
Last Update Date | 2021-08-25 |