NPI | 1467762799 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00247700) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00247700) |
Enumeration Date | 2010-10-20 |
Last Update Date | 2023-02-03 |