NPI | 1487675070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA001291L) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ MP000369) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2013-08-15 |